A Historic Chance to End Tuberculosis

By Lucica Ditiu and Peter Sands

in Voices on 13 March 2018

More than 10 million people around the world get sick every year with tuberculosis, and 40 percent of them fail to be diagnosed, treated or reported by health systems. Despite being curable, TB remains the leading cause of death from an infectious disease and the leading killer of people with HIV. An airborne disease, TB represents a global health security threat and remains most prevalent among the poor.

By any standard, the 5,000 people who die of TB every day is an unacceptable level of human suffering and economic burden. In September, heads of state have a unique opportunity to raise their game and decisively shift the trajectory of the disease with the United Nations General Assembly High-Level Meeting on TB.

But we need to get our act together now. India’s Prime Minister Narendra Modi will be guest of honor at this week’s Delhi TB Summit in India, where WHO and Stop TB Partnership will launch a joint initiative aimed at finding 4 million missing people with TB. The initiative will be built on a Global Fund program with Stop TB, WHO and partners, which will contribute to finding an additional 1.5 million people with TB in 13 countries by 2020. We hope such efforts will ignite concrete political leadership and action on the ground to end TB.

India has about 27 percent of the estimated global cases of TB, as well as a quarter of drug-resistant TB patients. Prime Minister Modi is showing extraordinary leadership and political commitment by calling for India to end tuberculosis by 2025, five years ahead of the global target. Moreover, the government of India has almost doubled the budget for tuberculosis in the financial year 2017-2018, and has allocated an additional US$100 million for 2018-2019 to alleviate the financial burden on TB patients during the course of their treatment. We want to see this kind of leadership replicated in all 30 high-burden countries.

There are clear economic reasons for protecting India and the world from infectious disease. A 2017 report by the Global TB Caucus examining how the global economy would be affected if the TB crises continues unabated estimated that deaths from TB will cost the global economy close to US$1 trillion over the next 15 years.

As the main cause of death from antimicrobial resistance, TB also poses a threat to global health security. About a third of AMR-related deaths are caused by drug-resistant TB. If we want to confront the growing threat of antimicrobial resistance we have to tackle the TB challenge as a priority. In our interconnected world, drug-resistant TB represents a potentially catastrophic risk to global health security. Global health stakeholders must get better at making the economic and security case, so these priorities and tradeoffs are present on a finance minister’s desk when he or she makes budget allocation decisions.

For quite some time, the TB community has rightly complained that the disease does not get the attention it warrants, despite the fact that it kills more people than other infectious diseases that regularly make headlines.

The UN High-Level Meeting on TB is a historic opportunity to ensure TB gets on the agenda of the heads of states and governments, and that we get different sectors engaged and accelerate our efforts to put the world on course to ending TB. We should start by changing the status quo to move toward a comprehensive standard of care for TB. We must also seek new sources of financing; more efficient case finding, diagnosis and treatment; put people with TB at the center of the response; help countries move toward universal health systems; increase research for TB and ensure that human rights and equity are protected.

As India’s Prime Minister Modi recently said: “We cannot allow such human tragedies for a disease that is treatable and for which drugs and diagnostics are available in the public health care system.” We must take advantage of this opportunity to deliver results, because we might not have the same chance again in the foreseeable future.